| [Background and Aims] The morbidity of virus-induced hepatitis is very high in China, most of which are hepatitis B. Chronic patients and virus carriers are not only the main source of infection, also the susceptible population for liver cirrhosis and hepatocellular carcinoma. Most recently, hepatitis C patients infected by blood transfusion are on the horizon. Chronic hepatitis C is inclined to liver cirrhosis and hepatocellular carcinoma as well. The severe complications of liver cirrhosis include massive bleeding from the upper alimentary tract, hepatic encephalopathy, primary carcinoma of the liver and so on. The goal of treating cirrhosis is to sustain or improve liver function and to prevent complications. Liver volume reflects the amount of liver cells, and has been considered as the same important index as Child-Pugh classification, which is used to evaluate liver reserve function. We measured the volumes of the whole liver, the left lateral segment and the caudate lobe in normal controls and virus-induced cirrhosis patients with the help of 16slices helical CT, explored the correlation between hepatic lobe variation and the severity of cirrhosis.[Method] 1. Volume CT scans were performed in 101 virus-induced cirrhosis patients confirmed by clinical manifestation, laboratory examination, ultrasound and CT, including 39 cases of Child-Pugh A, 38 cases of Child-Pugh B and 24 cases in Child-Pugh C. Another 113 patients with normal livers underwent the same CT examinations served as normal controls. The volumes of the whole liver, the left lateral segment and the caudate lobe were measured respectively, the per BSA(body surface area) volume of the whole liver(TLV), the left lateral segment(LLS), the caudate lobe(CL), the proportion of the left lateral segment and the caudate lobe volume to the total liver volume(LLS/TLV,CL/TLV) were also calculated.2. Standard liver volume formula was deduced based on body height(BH), body weight(BW) of BSA from the 113 normal controls. Then the formula liver volume(FLV) was obtained for every one of the case group using this formula. Volume index(volume index=CTLV/FLV) and volume change ratio {volume change ratio=(FLV-CTLV)/FLV×100%} were calculated and compared with Child-Pugh classification.[Results] 1. The standard liver volume formula SLV(cm~3)= 882.08×BSA(m~2) -308.12 or SLV(cm~3)=12.90×BW(kg)+437.91. The volume index of Child C grade was 0.66±0.18, significantly lower than Child A.B grade, at the same time, volume change ratio of Child C grade was (33.72±18.05) %, significantly higher than Child A.B grade(P<0.05).2. The volume of the whole liver, the left lateral segment and the caudate lobe were (1222.76±216.96) cm~3,(201.96±59.11)cm~3 and (27.66±18.16) cm~3 respectively. The proportion of the left lateral segment and the caudate lobe volume to the total liver volume were (16.63±4.37) % and (2.25±0.76) % respectively. The whole liver of Child C grade was significantly atrophied with its volume (798.01±203.64) cm~3(P<0.05). The volume of the left lateral segment of Child A.B grade were (313.18±105.10) cm~3 and (282.17±136.15) cm~3, significantly largger than Child C grade(213.05±74.84)cm~3(P<0.05). The volume of the caudate lobe significantly hypertrophied in Child A grade, which was (36.83±22.11 )cm~3(P<0.05), yet the volume didn't change significantly in Child B, C grade (29.23±14.93) cm~3 and (21.86±10.19) cm~3(P>0.05). The proportion of the left lateral segment and caudate lobe volume to the total liver volume was higher in all the grade of the hepatic cirrhosis group than that of the control group(P<0.05).[Conclusion] The 16 slices helical CT was helpful in measuring the volumes of hepatic lobes. In early stage of cirrhosis, the whole liver volume didn't change much, in Child C grade , the whole liver atrophied and its volume change ratio was also the most significantly. The enlargement of the left lateral segment was absolute in Child A.B grade, but was relative in Child C grade. The enlargement of the caudate lobe was absolute in Child A class, relative in Child B,C grade.
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